Peri‐operative care of patients undergoing robotic‐assisted bronchoscopy under general anaesthesia – a single‐centre retrospective cohort study

Summary Bronchoscopic procedures are increasingly performed with shape‐sensing robotic‐assisted bronchoscopy under general anaesthesia, allowing biopsy of small and distal pulmonary lesions. We performed a retrospective cohort study at a single centre of patients undergoing robotic bronchoscopy to describe the peri‐operative care. The primary outcome measure was post‐procedural length of hospital stay, with secondary outcomes including complication rates and diagnostic success of biopsy. A total of 200 patients were recruited over a 12‐month period. Median ([IQR] range) post‐procedural length of stay was 4 h ([2.5–24.5] 0.5–75) with 106/200 (53%) of patients performed as a day case. Cardiorespiratory comorbidities were common, 65% of patients had an ASA physical status 3 or 4. Higher ASA physical status and chronic obstructive pulmonary disease were associated with increased post‐procedural admission rate. All patients underwent general anaesthesia with target‐controlled infusion of propofol. Neuromuscular blocking agents were used in 194/200 (97%) and remifentanil was used for 185/200 patients (93%). Median PEEP was 10 cmH 2 O (range 5–15 cmH 2 O). The incidence of peri‐procedural complications requiring intervention was 6%. Our findings suggest that robotic‐assisted bronchoscopy could be delivered safely as a day case procedure in a population with a high incidence of comorbidities, with low peri‐procedural complication rates.